6 Facts About Rheumatoid Arthritis You Should Not Ignore

Rheumatoid arthritis (RA) is a common disease that affects millions of people around the world. The Arthritis Foundation of Malaysia states that approximately 5 in 1,000 people suffer from RA in Malaysia alone.  

An autoimmune and inflammatory disease, RA occurs within the joints, especially in the knees, hands, and wrists. For RA patients, their immune system mistakenly attacks the synovium, a lining surrounding the joint responsible for smooth movements. This causes the synovium to become inflamed, resulting in pain, stiffness, and swelling around the affected area. 

While it’s a common illness, many people confuse RA with another joint condition, osteoarthritis. According to TCM physician Ng Qing Xiang from Eu Yan Sang TCM Clinic, these are not the same.

“Most patients may think their pain problems are related to RA, but it turns out to be osteoarthritis (OA). OA is a degenerative disease, so older people are more prone to it. Meanwhile, RA is an autoimmune disease that can happen to anybody regardless of age. The patient may also experience other problems unrelated to the bones, such as lungs, kidneys, heart, and eyes.”  

Let’s look at six key Rheumatoid Arthritis facts that would help you understand the disease better and find the right treatment to manage the symptoms well.

1. Rheumatoid Arthritis Can Happen at Any Age and to Anyone

According to the Arthritis Foundation of Malaysia, the most common age for the disease to start is between 30 to 50. Women are also more likely to have this condition than men. While RA can begin at any age, the likelihood increases with age. The Centers for Disease Control and Prevention finds that the onset of RA is highest among adults in their sixties. 

Among those at high risk of RA include people born with the HLA (human leukocyte antigen) class II genes, women who have never given birth, and individuals suffering from obesity. Environmental factors like smoking cigarettes also increase the risk of RA. In fact, it’s not just the smoker that is at risk. A study found that children whose mothers smoked are twice as likely to develop RA when they grow up. In contrast, mothers who breastfeed may decrease their risk for RA.

2. Specific Causes of Rheumatoid Arthritis Are Unknown

Although we know that RA is due to abnormal autoimmune responses, doctors still do not know what causes the immune system to attack the joints in a patient with RA. However, from a Traditional Chinese Medicine (TCM) point of view, external pathogens are a potential cause of this disease.

“In TCM perspective, rheumatoid arthritis belongs to the bi syndrome category, referring to any pain and numbness of the muscles, tendons, and joints. RA may result from external pathogens such as wind, cold, dampness, and heat,” says physician Ng. 

“When these external pathogens attack the body, it obstructs the flow of blood and qi (vital life energy) in the body’s meridians. Since it’s an autoimmune disease, RA can also randomly attack other parts of the body apart from the joints and tendons.”

3. Rheumatoid Arthritis Presents a Wide Range of Symptoms

The symptoms of this autoimmune and inflammatory disease vary, and they might get better or worse at times. Some of the common ones include: 

• Pain and swelling in multiple joints, often starting with the fingers 
• Stiffness in the joints, especially in the morning, lasting an hour or more 

• Affected areas around the joints can appear red and feel warm 
• Similar symptoms on both sides (i.e., feeling pain in both knees or swelling in both hands) 
• Fever 
• Fatigue and weakness 
• Weight loss and loss of appetite  

RA may also cause body-wide symptoms like cardiovascular diseases, blood disorders, lung disease, eye disorders, and weakening of bones. This condition can affect the kidneys, salivary glands, nerves, and bone marrow.

4. Different Kinds of Rheumatoid Arthritis Treatments are Available

There are many ways to manage RA: medication, joint care, self-management strategies, or as a last resort, surgery. Western medicine uses pain killers, non-steroidal anti-inflammatory drugs (NSAIDs), and steroids to control the pain. Other drugs called disease-modifying anti-rheumatic drugs (DMARDs) and biological therapy can slow the progression of the disease and prevent relapses. While these can help alleviate symptoms and delay the progression of the disease, they are associated with many side effects.

5. TCM is an Alternative to Treat Rheumatoid Arthritis

TCM provides a non-invasive way to counter RA symptoms using herbal formulas and remedies. “The treatment for RA patients is generally to eliminate the external pathogens and improve vital energy as well as blood circulation,” says Physician Ng, adding common herbal formulas like Juan Bi Tang (蠲痹汤) and Du Huo Ji Sheng Tang (独活寄生汤).

“These two contain herbs such as Du Huo (独活 Angelicae Pubescentis Radix), Qiang Huo (羌活, Notopterygium roots), ginseng (人参), and angelica roots (当归). However, herbal prescriptions need to align with a patient’s syndrome differentiation,” she notes. 

Physician Ng emphasizes the importance of consulting a TCM physician to get an accurate diagnosis and appropriate treatment. As RA affects other systems in the body besides pain and swelling in multiple joints, the physician must consider the patient’s entire body.

“(Juan Bi Tang and Du Huo Ji Sheng Tang) are more suitable for people with cold, wind, and dampness syndrome. They are less suited for individuals with a “heaty” body constitution – those who have frequent sore throats, constipation, or if the affected area is warm to touch, swollen, and reddish,” physician Ng adds.

Acupuncture can also effectively treat numbness of joints, muscles, and tendons by improving blood circulation of the localised area while boosting vital energy, liver, and kidney deficiency.

“Generally, we have a point called He Gu (LI 4) to improve the overall energy and blood circulation. But the points depend on the person’s afflicted areas. First, the patient must consult a physician, then we can decide what points to use,” says Physician Ng.

6. There’s No Cure for Rheumatoid Arthritis, but You Can Manage the Symptoms

Unfortunately, RA is not curable. However, when RA patients manage their symptoms well, it leads to a better quality of life. From a TCM perspective, managing RA symptoms is about ensuring a good flow of vital energy to strengthen immunity and support the internal systems. Staying active and performing low-impact exercise helps maintain your joint mobility and strengthen your muscles. 

“Humans store vital energy, or qi, that can help prevent external pathogens from attacking the body. Patients should avoid doing things that deplete their vital energy – for example, staying away from extreme temperature and humidity (too cold, hot, or wet). Also, have sufficient rest, exercise regularly, and have a balanced diet. A healthy way of life also helps to support our liver and kidneys, which closely link to our tendons, bones, and joints,” physician Ng notes.

Diet is a crucial factor too. In TCM, the right kind of diet depends on the individual. “People who have RA due to cold pathogens should eat foods that are warm in nature like ginger and cinnamons. Those with RA due to “heatiness” should eat cold-natured foods to avoid excessive heat. The objective is to maintain a neutral body constitution,” she explains. 

You can also consider healthy food products to supplement a healthy diet plan, e.g., an oat powder drink with turmeric or curcumin that helps with inflammation in the body. 

The key to getting RA under control is to seek diagnosis and get treatment as early as possible. This way, you can learn how to manage the symptoms better. With different treatment plans and self-management strategies out there, it is possible to live a good life even if there’s no cure for this disease.